There are several different types of seizures in children. Pediatric seizures can be categorized as two broad types, focal and generalized:
Focal seizures
Pediatric focal seizures take place when abnormal electrical brain function occurs in one or more areas of one side of the brain. Focal seizures may also be called partial seizures. With focal seizures, particularly with complex focal seizures, the child may experience an aura before the seizure occurs. An aura is a strange feeling, either consisting of visual changes, hearing abnormalities, or changes in the sense of smell. There are two sub-types of focal seizures to be aware of.
Simple focal seizures in children typically last less than one minute. The child may show different symptoms depending upon which area of the brain is involved. If the abnormal electrical brain function is in the occipital lobe (the back part of the brain that is involved with vision), the child's sight may be altered. The child's muscles are typically more commonly affected. The seizure activity is limited to an isolated muscle group, such as fingers or to larger muscles in the arms and legs. Consciousness is not lost in this type of seizure. The child may also experience sweating, nausea, or become pale.
Complex focal seizures in children commonly occur in the temporal lobe of the brain, the area of the brain that controls emotion and memory function. This seizure usually lasts between one to two minutes. Consciousness is usually lost during these seizures and a variety of behaviors can occur in the child. These behaviors may range from gagging, lip smacking, running, screaming, crying, and/or laughing. When the child regains consciousness, the child may complain of being tired or sleepy after the seizure. This is called the postictal period.
Generalized seizures
Generalized pediatric seizures involve both sides of the brain. There is loss of consciousness and a postictal state after the seizure occurs. There are multiple sub-types of generalized seizures, each common during different ages of adolescence and occurring with different symptoms.
Absence seizures
Pediatric absence seizures (also called petit mal seizures) are characterized by a brief altered state of consciousness and staring episodes. Typically the child's posture is maintained during the seizure. The mouth or face may move or the eyes may blink. The seizure usually lasts no longer than 30 seconds. When the seizure is over, the child may not recall what just occurred and may go on with his/her activities, acting as though nothing happened. These seizures may occur several times a day. This type of seizure is sometimes mistaken for a learning problem or behavioral problem. Absence seizures almost always start between ages 4 to 12 years.
Atonic Seizures
With atonic seizures in children (also called drop attacks) there is a sudden loss of muscle tone and the child may fall from a standing position or suddenly drop his/her head. During the seizure, the child is limp and unresponsive.
Generalized tonic-clonic seizures
This seizure (GTC or also called grand mal seizures) is characterized by five distinct phases that occur in the child. The body, arms, and legs will flex (contract), extend (straighten out), tremor (shake), a clonic period (contraction and relaxation of the muscles), followed by the postictal period. During the postictal period, the child may be sleepy, have problems with vision or speech, and may have a bad headache, fatigue, or body aches.
Myoclonic seizures
This type of seizure refers to quick movements or sudden jerking of a group of muscles. These seizures tend to occur in clusters, meaning that they may occur several times a day, or for several days in a row.
Infantile spasms
This rare type of seizure disorder occurs in infants from before six months of age. There is a high occurrence rate of this seizure when the child is awakening, or when they are trying to go to sleep. The infant usually has brief periods of movement of the neck, trunk, or legs that lasts for a few seconds. Infants may have hundreds of these seizures a day. This can be a serious problem, and can have long-term complications.
Febrile seizures
Pediatric febrile seizures are associated with fever. These seizures are more commonly seen in children between 6 months and 5 years of age and there may be a family history of this type of seizure. Febrile seizures that last less than 15 minutes are called "simple," and typically do not have long-term neurological effects. Seizures lasting more than 15 minutes are called "complex" and there may be long-term neurological changes in the child.